8/17/2023 EnchantaVaughn Approved Behavior: Client displayed excellent transition, as QMHP greeted her for today's services. Client presented well-mannered behaviors as she prepared for the session to start. Client was observed interacting well within the home and asking appropriate questions. Client was observed in the session displaying good behaviors and expressing a positive attitude. Client maintains an excellent attitude, demonstrating a good rapport with QMHP. No redirection was needed at this time. The client was acknowledged for managing her anxiety on her own. Behavior: Client transitioned into the next activity without conflict and proceeded to engage into meaningful conversation. Client was observed asking and answering appropriate questions. Client exhibited excellent communication skills by being polite and patient creating a positive working atmosphere. Client was observed making good choices and avoiding negative behaviors. Client was relieved to know that she wasn’t alone and that many girls her age go through the same things. Intervention: QMHP modeled pro-social behaviors for client to strengthen her understanding of them. QMHP intervened to prevent the negative behaviors from escalating. QMHP praised client for her efforts and being respectful to her mom. QMHP discussed with client how empathy, communication, and awareness of another point of view can prevent or reduce conflicts. QMHP brainstormed with client a list of conflicts that typically occur in her life in efforts to identify possible conditions or triggers that preceded the actual conflict. QMHP prompted client to share anticipated thoughts and feelings and to indicate how this process reduces angry reactions. Intervention: QMHP held consultations with client and mother about effective intervention strategies that build on the client's strengths and compensate for her negative behaviors. QMHP encouraged client’s mother to provide frequent positive reinforcement to maintain client's interest and motivation in maintaining positive home behaviors and completing her individual home tasks. QMHP offered help. QMHP inquired about upcoming weekend activities, asking what she had planned and what she looked forward to the most. QMHP challenged client to continue displaying a positive attitude while employing positive reinforcement when client is able to achieve a goal. Response: Client engaged in self-reflection and reflected on her day in front of mom and seemed happier and more open minded following one on one. Client reflected on her weekend plans regarding completing therapy assignment, chores, and other duties. Client was acceptive of encouragement and decided to listen to her mother and do the right thing. Client was seen following desired rules and expectations without requiring redirection or additional breaks. Mom continues to support this behavior in the home. Response: Client acknowledged interventions and verbalized clear understanding of each intervention. Client engaged in reflective thinking and expressed her feelings to QMHP. Client shows empathy towards mom, as evidenced by her hugging, playing, smiling, and complimenting her. Client avoids negative language (i.e. profanity words). Client was in a pleasant mood after feedback was given. Client was seen having a good time. Client was able to identify the role she plays in each situation and continues to comply with authority rules and regulations.